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GOUT

GOUT. TAHIRA KHAN UG-3B. INTRODUCTION:. GOUT is known as the “disease of kings “ and “rich man’s disease”. Gout  (also known as  podagra  when it involves the big toe )

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GOUT

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  1. GOUT TAHIRA KHAN UG-3B

  2. INTRODUCTION: • GOUT is known as the “disease of kings “ and “rich man’s disease”. • Gout (also known as podagra when it involves the big toe) • it is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis-red, tender, hot, swollen joints • Gout is a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation. • Gout effects more men then woman in them occurs after menopause http://www.jfootankleres.com/content/pdf/1757-1146-4-13.pdf

  3. CAUSES • Hyperuricemia is the underlying cause of gout. • diet, genetic predisposition, or underexcretion of urate • Low uric acid level in blood • the exact cause is unknown. • Partly genetic cause in the genes  contributing to about 60% of variability in uric acid level • ThreegenesSLC2A9, SLC22A12 and ABCG2 have been found to commonly be associated with gout, and variations in them can approximately double the risk • Loss of function mutations in SLC2A9 and SLC22A12 cause hereditary hypouricaemia by reducing urate absorption and unopposed urate secretion www.ncbi.nlm.nih.gov

  4. SYMPTOMS • gouty arthritis • Acute gouty arthritis in big toe(podagra) • Kidney stones • Acute pain in joints • Uric acid crystal depositon in the form of tophi • Tophi in ear lobe, achilles ankle and elbow • Fatigue • Mailase • High uric acid levels http://www.aafp.org/afp/1999/0215/p925.html

  5. TYPES OF GOUT • Depending upon the symptoms and severity of disease gout is classified into • Acute gout • Chronic gout

  6. ACUTE GOUT • Acute gout is a painful condition that typically affects one joint • Symptoms usually involve only one or a few joints. The big toe, knee, or ankle joints are most often affected. • throbbing, crushing, or excruciating pain • joint appears warm and red • fever. • The attack may go away in a few days, but may return from time to time. Additional attacks often last longer. • After a first gouty attack, people will have no symptoms. Half of patients have another attack. http://www.aafp.org/afp/1999/0215/p925.html

  7. CHRONIC GOUT • Those with chronic arthritis symptoms include: • joint damage and • loss of motion in the joints. • joint pain and other symptoms most of the time. • Tophi below the skin around joints or in other places. Tophi usually develop only after a patient has had the disease for many years. http://www.aafp.org/afp/1999/0215/p925.html

  8. DIAGNOSTIC TESTS • Synovial fluid analyis (shows uric acid crystals) • Uric acid – blood • BUN (blood urea nitrogen • Joint x-rays (may be normal) • Synovial biopsy • Uric acid – urine • Creatninelevel

  9. BIOCHEMICAL TESTS FOR GOUT:

  10. EXAMINATION OF SYNOVIAL FLUID • ASPIRATION: • The health care provider uses a needle attached to a syringe to draw out fluid from the affected joint. • LAB ANALYSIS: • The fluid sample is sent to a laboratory for analysis. Testing can reveal the presence of monosodium urate (MSU) crystals, which will nearly always confirm a diagnosis of gout. The laboratory can also test the sample for infection. • The procedure itself can cause infection, though this occurs in less than 0.1% of patients. Aspiration sometimes eases the patient's symptoms by reducing swelling and pressure on the tissue surrounding the joint. http://www.umm.edu/patiented/articles/what_risk_factors_gout_000093_5.htm#ixzz2BBsc1QLS

  11. TREATMENT COLCHICINE Produces its anti-inflammatory effects by binding to the intracellular protein tubulin, preventing its polymerization leading to the inhibition of leukocyte migration into affected area. Inhibits the synthesis & release of leukotrienes. • NSAID,s • Colchicine • Uricosuricagents • Allopurinol

  12. CONTINUED

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